Individual
MISS DIANNE FONG CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2481 CREEKSIDE CT, HAYWARD, CA 94542-2359
(510) 326-6696
Mailing address
706 CROCUS DR, SAN LEANDRO, CA 94578-3811
(510) 326-6696
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT6777
CA
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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